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February 28, 2013

HIV Accelerates Liver Fibrosis by Nearly a Decade Among People With Hep C

The severity of liver fibrosis among those coinfected with hepatitis C virus (HCV) and HIV is comparable to fibrosis found in people monoinfected with hep C who are nearly 10 years older, MedPage Today reports. Publishing the findings of their National Institute on Drug Abuse–funded study in the Annals of Internal Medicine, researchers at Johns Hopkins School of Medicine examined 1,176 current and former injection drug users living with HCV and compared liver fibrosis by age between monoinfected and coinfected patients. In addition to assessing liver fibrosis every six months between 2006 and 2011, the investigators took a medical history, asked questions about alcohol and drug use and measured HCV RNA levels, hepatitis B virus (HBV) surface antigen levels, body mass index (BMI) and, for the HIV-positive participants, CD4 counts and viral loads.

The median age of the cohort was 49, and 34 percent were coinfected. The investigators took 5,634 liver fibrosis measurements over the course of the study. Between the coinfected and monoinfected participants, the respective prevalence of clinically significant fibrosis without cirrhosis was 12.9 and 9.5 percent; the respective prevalence of cirrhosis was 19.5 and 11 percent. Variables independently associated with liver fibrosis were older age, HIV infection, daily alcohol use, chronic hepatitis B infection, a BMI above 25 kg/m2 and higher HIV viral load. Factoring out these other variables, coinfected people had liver fibrosis measurements equivalent to monoinfected participants who were an average of 9.2 years older. The study is limited by the fact that liver fibrosis had already begun for most participants before they entered the study.

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